Asperger's Syndrome and Depression in Teens

Eileen Bailey Health Guide
  • Although the reasons are not well understood, teenagers and adults with Asperger's syndrome (AS) seem to be more vulnerable to depression. According to Nomi Kain, an Aspie with depression, "It is unclear whether this depression emerges as a result of the struggles, exhaustion, rejection and failures so often present in a life with Asperger's Syndrome, or whether the mysterious neurology of AS somehow invites, or includes, a hard-wired affective disorder." [1]


    According to some experts and Aspies, depression in Aspies may be the result of the many self-perceived failures. For example:

    • Feeling left-out or not fitting in with peers
    • Guilt or regret over past actions including meltdowns or outbursts that caused physical or emotional pain to someone else
    • Not understanding or knowing how to cope with overwhelming emotions
    • Rejection because of misunderstandings and miscommunications
    • Feeling alone because of inability to fully understand the world
    • Fatigue from coping with meltdowns or exhaustion from trying to fit in

    Difficulty in Recognizing Depression in Aspies

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    One of the problems with diagnosing and treating depression in Aspies comes from the very nature of AS. Aspies have a difficult time talking about emotions. Many would prefer, and do, think about ideas rather than feelings. Aspies have a hard time with non-verbal communication. Facial expressions and other non-verbal communication often give clues into our emotions, but for Aspies, non-verbal communication is minimal and signs of depression can go unnoticed.


    Some of the signs of depression in Aspies are:

    • Changes in appetite, either eating more than previously or loss of appetite
    • Changes in mood, such as increased irritability
    • Loss of desire to engage in special interest
    • Reluctance to go to school or leave the house
    • Refusal to participate in any outside activities
    • Withdrawal from family and family activities
    • Loss of skills already established

    Treatment of Depression for Individuals with Asperger's Syndrome


    Antidepressant medication is often used to treat depression and this is true for those with AS as well. However, the cause of the depression needs to be taken into consideration. For example, if a teen with AS is feeling depression because of his inability to fit in or consistent failures in trying to make friends, then social skills need to be addressed. Medication alone may help him be better able to cope with emotions, but it will not provide relief from the underlying cause of the depression. In conjunction with medication, then, parents and therapists need to work on specific skills such as social skills training and providing opportunities to meet teens who share his interests.


    As with all treatment of depression, medication works differently for each person. You and your teen may need to try several different medications and dosages to find what works best for him. While it can be more difficult because your teen may not be able to express feelings, it is important to keep the lines of communication open and work together to find medication to help him feel his best.


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    When looking for a therapist, make sure the therapist has a clear and thorough understanding of AS in teens. Otherwise, the therapist may feel the inability to share emotions is a form of defiance and refusal to participate in counseling sessions. According to the Asperger's Syndrome Foundation, there are a few ways therapy can be adjusted to better fit the needs of teens with AS:

    • Have a clear structure, e.g. protocols of turn-taking
    • Adapt the length of sessions. Therapy might have to be very brief, e.g. 10-15
    • minutes long
    • The therapy must be non-interpretative
    • The therapy must not be anxiety provoking as any arousal of emotion during
    • therapy may be very counterproductive
    • Group therapy should not be used [2]

    The role of therapy should be to help your teen change the way he thinks about situations and events, how he reacts to feelings and to provide new skills, such as social skills or anger management. Therapy should always be focused on the individual, that is, your child has his own unique needs and these should be addressed rather than adopting a "one size fits all" mentality toward counseling.




    "Asperger's Disorder," 2000, Carol E. Watkins, M.D., Northern County Psychiatric Associates


    [1] "Asperger's and Depression: Inside a Common Paradox," Date Unknown, Nomi Kaim, Asperger's Association of New England


    [2] "Information Sheet: Depression or Mental Health Problems," Date Unknown, Asperger's Syndrome Foundation


Published On: January 03, 2012